Car crash trends for the poor run in re­verse, study shows.

The Washington Post Sunday - - BUSINESS - BY EMILY BADGER AND CHRISTO­PHER IN­GRA­HAM emily.badger@wash­post.com christo­pher.in­gra­ham@wash­post.com

Traf­fic fa­tal­i­ties in the United States have been plum­met­ing for years, a ma­jor vic­tory for reg­u­la­tion (strict drunken-driv­ing laws have helped) and auto in­no­va­tion (we have safer cars). But that progress ob­scures a sur­pris­ing type of in­equal­ity: The most dis­ad­van­taged are more likely — and have grown more likely over time — to die in car crashes than peo­ple who are well off.

New re­search by Sam Harper, Thomas J. Char­ters and Erin C. Strumpf, pub­lished in the Amer­i­can Jour­nal of Epi­demi­ol­ogy, finds that im­prove­ments in road safety since the 1990s haven’t been evenly shared. The big­gest declines in fa­tal­i­ties have oc­curred among the most ed­u­cated. As for peo­ple 25 and older with less than a high school diploma, fatality rates have in­creased over time, buck­ing the na­tional trend.

The un­der­ly­ing is­sue here is not that a col­lege de­gree makes you a bet­ter driver. Rather, the least ed­u­cated tend to live with a lot of other con­di­tions that can make get­ting around more dan­ger­ous. They own cars that are older and have lower crash-test rat­ings. Those with less ed­u­ca­tion are also likely to earn less and to not have the money for fancy safety fea­tures such as side air bags, au­to­matic warn­ings and rear cam­eras.

The num­ber of trauma cen­ters, the re­searchers point out, has also de­clined in poor and ru­ral com­mu­ni­ties, which could af­fect the health care that peo­ple have ac­cess to af­ter a col­li­sion. And poor places suf­fer from other con­di­tions that can make the roads safe. In many cities, poor com­mu­ni­ties lack cross­walks over ma­jor roads. The res­i­dents who live there may have less po­lit­i­cal power to fight for de­sign im­prove­ments such as stop signs, side­walks and speed bumps. As a re­sult, pedes­trian fa­tal­i­ties, in par­tic­u­lar, are higher in poor com­mu­ni­ties.

“It’s true that there are big dif­fer­ences in the qual­ity of the residential en­vi­ron­ments that peo­ple have in terms of their risks of ac­ci­den­tal death as pedes­tri­ans,” Harper says.

The role of be­hav­ioral dif­fer­ences is murkier. Some stud­ies show lower seat-belt use among the less-ed­u­cated, but seat-belt use has also in­creased faster among that group over time, mean­ing so­cioe­co­nomic dif­fer­ences there are nar­row­ing.

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